Voices’ Blog

Children’s Mental Health: 2019 Session Wrap-up

Posted:  -  By: Ashley Airington

Over the last several years, behavioral health has been a primary focus for policymakers in Virginia. Efforts made by the Deeds Commission, as well as our Medicaid and behavioral health agencies, have signaled Virginia’s dedication to transforming our behavioral health system for children and adults. We are pleased that legislators kept up the momentum for change and made significant investments in our behavioral health system during the 2019 session to ensure that adults and children have access to needed mental health services.

Improved integration of children’s mental health services in primary care by establishing a pediatric mental health access program in Virginia. We are thrilled that the final budget includes $1.23 million per year to build out state-wide capacity for the Virginia Mental Health Access Program . VMAP will improve the identification and treatment of children’s mental health needs by offering physicians specialized children’s mental health training, access to on-demand behavioral health consultation services with child psychiatrists, and care coordination to identify regional mental health resources (like outpatient therapy) for children in need.  Check out media coverage of VMAP and learn more here.

Addressed high-utilization at state mental health hospitals, including the Commonwealth Center for Children and Adolescents. The Commonwealth Center for Children and Adolescents (CCCA), the only state funded children’s in-patient psychiatric hospital, has experienced significant census pressures in the last few years that have resulted in children being held in emergency rooms until beds become available at the center. We are pleased that the legislature is taking steps to address hospital census issues in Virginia by doing the following:

1) Allocating $850,000 to support step-down mental health services for high-risk children at CCCA who no longer need hospital-level care but still require specialized intensive mental health services.

2) Directing the Dept. of Behavioral Health and Developmental Services to establish a workgroup to examine the impact of Temporary Detention Order (TDO) admissions on state mental health hospitals in Virginia and develop options and an action plan to relieve hospital census pressure.

3) Directing the Secretary of Health and Human Resources to convene a workgroup to examine the causes of census pressures at our state hospitals, including the impact of Emergency Custody Orders and the treatment needs of adults and children with complex medical conditions.

Improved access to children’s mental health crisis services through continued implementation of STEP-VA.  This year, the General Assembly allocated an additional $7.8 million per year to create crisis services for children and adults at all 40 community services. Funding to support specialized crisis services, like crisis stabilization units and mobile crisis services, is intended to help children avoid costly in-patient psychiatric hospital stays. We are pleased that the legislature continues to invest significant state funding to build out STEP-VA, Virginia’s plan for improving statewide community-based mental health services for children and adults.

Steps to address coordination of mental health needs in schools. Several bills were purposed to coordinate mental health needs or services in schools this session, including: mental health instruction in schools, Mental Health First Aid training for all public school teachers, the establishment of a Commission on Student Behavioral Health, and the establishment of a School-Based Health Center Joint Task Force. While we are disappointed that most of these measures failed, we are thrilled that the Children’s Cabinet will establish a school-based health center workgroup that will explore the landscape of school-based services, develop best practice recommendations for trauma-informed school-based health centers, and evaluate funding mechanisms for school-based health center services.

Improved access to health and mental health services for low-income children by addressing workforce needs. It is well documented that Virginia has a shortage of licensed mental health professionals available to treat children and adolescents in need.  We are thrilled that the General Assembly took significant steps to increase Medicaid reimbursement rates for primary care physicians and licensed mental health providers that will improve access to necessary health care and specialized behavioral health services. Specifically, $7.2 million is dedicated to increasing Medicaid rates for mental health practitioners who bill for psychiatric services. Additionally, $15.2 million is allocated to increase primary care physician rates to 70 percent of Medicare rates. Lastly, SB1685 passed that allows for mental health providers to receive reimbursement for services rendered during pendency of mental health professional’s credentialing application. Currently, mental health providers can not receive reimbursement for services rendered until a managed care organization approves the providers credentialing application, which can sometimes be 4-6 months.


In all, the General Assembly invested over $17 million to improve our behavioral health system for children and took important steps to address behavioral health workforce needs.  A million thanks goes out to our wonderful partners who joined Voices in the fight to improve access for all children and adults in need of mental health services, the advocates who spent many hours calling, writing, and speaking to legislators about these important issues, and to our champions in the legislature who fight every year to make our behavioral health system better for all.


Questions? Contact Ashley Everette, Policy Analyst: ashley@vakids.org

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